> Build software for doctors' offices and medical groups!
Please please please go into these areas with humility. Having worked for health tech companies in SF for a decade, I've seen so many people come from Google/Facebook/Mozilla/Ticketmaster/eBay to healthcare in order to "disrupt" and "fix" it. Their disruption or fixes are many times illegal, impractical, vaporware, or completely ignore industry standards and so can't speak the same language as all the other tools in the ecosystem. It generally doesn't end well if you don't deeply partner with stakeholders and domain experts.
The above x100. Technology isn't a cheat code for a hard problem, it's just another tool. When we assume that tech fixes everything with no further research, everyone gets a lot worse off.
uBiome— you’d send fecal samples to them and they’d sequence and tell you what bacteria you have. They claimed to have clinical value and started billing insurance, before eventually being raided and shut down for something along the lines of insurance fraud.
This is why I keep emphasising on "domain knowledge". As an engineer my domain knowledge is zero when I wade into a new problem space.
A good way to approach is to partner with a domain expert to understand the following aspects.
1. Know about various stake holders that make up a business process. Understand each of their incentives. Some actors standout explicitly but some do not, such as regulators.
2. The value add by different player/stake holder in the chain.
3. Location of power centres. No one will explicitly call it out but you will be able to figure it out.
Now pick one stake holder or actor, go deep into their problems, and see how you can make their life easier without disrupting rest of the actors. This latter part is important. If there are three actors (A, B, and C) and your solution is intended to make life easy for "A" but requires B and C to disrupt their workflow without them getting anything in return then it'll be that much difficult for your solution to be adopted.
Also, at the end of the day automation is making someone (or part of someone) redundant. Make sure you identify that person and be subtle about your messaging to them.
All of this takes time so in olden days there used to be a role called "system analysts". Their job was to go deep into the problem domain, untangle all the above for you and help you define product. These analysts are typically ex-workers in the same domain so they have seen everything first hand. Given the nature of their job their role is not fungible in that you can't take one person and make them move around to be system analyst in different domains. Somewhere along the way system analyst role disappeared and they were replaced by fungible "product managers". These PMs have a generic set of product development skills such as UX, user retention optimisation etc., But they lack the domain knowledge. And they are expected to be fungible. If a PM changes job once every 3 years into a different domain they can at best do a superficial job.
Of the top of my head here are two examples.
There's this software called Docon (https://docon.co.in) used by small-setup medical doctors and physicians. The value add for doctors is very clear. It saves them time and all the hassle. What is good about Docon is it requires zero actions by the patient or any one else. So Doctors are happy to be using it. It is a nifty little tool to automate key parts of doctors' workflow.
Now let me talk about JIRA. It is mainly targeted towards management and execs. Because, let's face it, they have a genuine problem of not having clear view into project development state. They can't see how their quarterly projects are shaping up at different zoom levels. To that end I would say JIRA does a reasonably good job. Where JIRA fails spectacularly is it requires leaf level works to massively disrupt their workflow. Not only does it require them to use JIRA for daily updates and what not it also forces a way of agile development which comes with its own set of baggages.
Theranos, uBiome, and Practice Fusion all have well known scandals. I'm aware of other issues at some other health tech startups surrounding misrepresenting their impact on quality of care, building biased algorithms that have a discriminatory impact on care delivery, companies looking at questionable payment models that seem like they'd violate stark laws, straight up medicare fraud, etc. I'll just say that I'm skeptical of health tech companies that claim/suggest any impact on a medical condition, that claim to have a predictive algorithm related to a medical condition that's their core product, or that somehow give free things to providers.
To be fair I'd take that list and expand it to include the big pharmaceutical companies (see the new Alzheimers drug scandal at the FDA, billions spent on next generation statins that proved ineffective by confusing correlation and causation, etc), to include doctors and surgeons and various surgical practices or novel medical treatments (billions spent on full Meniscectomies that just lead to arthritis after years, pointless heart stints, etc).
True many startups in health are trying scammy payment models, but hospital bills often aren't much better unfortunately.
Personally my life has been positively improved by 23andme when they could still list health research, or by "zany" microbiome/probiotics startups years before the medical establishment caught up. Obviously these fields should be regulated, but properly so without just providing an excuse for regulatory capture for existing players.
Faxes are common in healthcare, and it's a common punch line from newcomers. But there's a series of standards that have been iterated on since the late 80s/early 90s that are finally getting to a place where they can eliminate faxes. There's standards for how to transmit data between EHRs, standards for how to store and represent data, and a standard API for 3rd parties to be able to write/read that data.
Regardless of these standards, you can already share data between hospitals using the same EHR -- so epic-to-epic (epic is the largest EHR vendor in the US) data sharing has been happening for a decade without any faxes. Unfortunately, there's a ton of different players in this game, so getting to a place where everyone has adopted the standards takes a long time, and the system still needs to keep running while this switch happens. To be clear, this is a common problem throughout tech: is it possible to run a native android app on iPhone? Do you think Google and Apple will ever make it possible to do that?
I can think of at least one medical company that builds their own technology and managed to paint themselves into a corner by not working from within the system. They just hire a bunch of engineers, who hear about how faxes run healthcare, so they say "cool, I can digitize the faxes" without bothering to consider or learn about other standards that are being developed. This leads to proprietary data models, with proprietary data representation, all transmitted using outdated technology. The engineers quit and go back to non-health tech, and tell their friends that health tech is so frustrating because it's so dated (make sure to bring your fax machine when you start your new job!).
But, really, the problem was never faxes. The problem is that healthcare is way more complicated, with way more stakeholders than consumer tech. You can't just launch a new product and iterate on the bugs later; people's lives are at stake, so the whole industry is heavily regulated. But if you enter with humility, recognizing that there is too much information for one person to know, but know that your skills are welcomed and needed. Take time to learn about things like HL7, FHIR, and clinical ontologies. And partner-- not just a quick knowledge sharing session-- actually partner with the domain experts, then there's a whole world of fascinating possibility out there.
Please please please go into these areas with humility. Having worked for health tech companies in SF for a decade, I've seen so many people come from Google/Facebook/Mozilla/Ticketmaster/eBay to healthcare in order to "disrupt" and "fix" it. Their disruption or fixes are many times illegal, impractical, vaporware, or completely ignore industry standards and so can't speak the same language as all the other tools in the ecosystem. It generally doesn't end well if you don't deeply partner with stakeholders and domain experts.